Events began on the evening of Thursday 9th January. I had had a fairly full day at work, and had just got home when Sheep telephoned to suggest that we ate out at a local restaurant (about twenty minutes walk away). I left the house and started walking, but was finding it rather hard-going and tiring. About ten minutes from the house, I began to feel a little ‘trickle’, then a sudden gush, as my waters broke (surprisingly dramatic). I was only grateful that I was wearing dark trousers, that I was on my own and that it was dark outside (and that I was not in the supermarket or another more public place). This was 6:00 pm. I turned around and started walking home, calling Sheep from my mobile to let him know what had happened. I then called our midwife, Debbie Pulley. Sheep joined me at home and we waited for something to happen. Nothing did.
Later that evening, we decided to go to sleep in the hope that something might start in the middle of the night. Little did we know, at this stage, that Debbie stayed awake all night, waiting for our phone call! We awoke the following morning and still nothing had started. It so happened that I had already had an appointment booked with my obstetrician for Friday morning; since I was only at 38 weeks, this was meant to be nothing more than a regular check-up. I rang his office at 9:00 am (now 15 hours after my waters had broken). Dr. Dott instructed me to attend and mentioned, almost in passing, that I might need to make a difficult decision. At this point Debbie rang and we confirmed that nothing had happened. She said that Dr. Dott might want to induce, if there was still no sign that labour had started, she said that once your waters have broken, an immediate time limit is set because of concern of iatrogenic infection (usually 12-24 hours). Although we had been getting ‘dual care’ (i.e. seeing both a midwife and an obstetrician for our prenatal care) we had been intending to have a home birth with Debbie attending. Ironically, we had everything prepared for a home birth, but had not even packed a bag in case of the eventuality that we might need to go into hospital in fact, we weren’t even sure what to take! That morning, Sheep packed a few things, and we drove off to see the obstetrician, Dr. Dott, still not really believing that we would end up in hospital.
We arrived at the obstetrician’s practice at 10:30 am on Friday morning (10th) and saw Dr. Dott immediately. He checked to see if my waters really had broken and if I had begun to dilate still nothing, no sign of impending labour whatsoever. Dr. Dott said that we had no choice; we were to check into Northside hospital immediately and have it induced (it was now approaching 17 hours since my waters had broken). By 11:00 am we were in a room (room C3) in Northside hospital, filling in forms.
At approx. 12:00 12:30 pm they gave me Cervidil, a vaginal insert (a cross between a suppository and a tampon) containing prostaglandin, a hormone used to help the cervix ripen. In some cases, it may be sufficient, on its own, to induce labor. It has to stay in place for twelve hours. Unfortunately, patients have to remain in a supine position for two hours following insertion this meant that I missed lunch. A very boring twelve hours followed (this is when Sheep sketched me). By midnight I was experiencing some gentle, regular contractions, but was not in active labour. Hence, at about 12:00 12:30 am, on the morning of Saturday 11th, I was put on an intravenous (IV) drip comprising of separate feeds of glucose, penicillin (because of my waters breaking and the risk of infection) and pitocin (a synthetic form of oxytocin). The pitocin is used to induce contractions. Within ten minutes of being on the pitocin, I was having fairly strong contractions 3 to 4 minutes apart. This continued through to the early hours of the morning, whilst Sheep and I watched DVDs and breathed together through the contractions. (Actually, I’d been deeply skeptical about the benefit of ‘breathing’, but it did seem to work and Sheep was great at breathing with me throughout this stage). One major irritation that I had with the hospital birth was my inability to move about by this stage I was wired up to two monitors (fetal heart beat and contractions) as well as the IV drip. It was almost impossible for me to move about. At one stage, I felt that I wanted to get on my hands and knees; after five minutes of rearranging cables and tubes I was able to achieve this only to discover that the presence of the IV drip in my lower arm meant that I couldn’t really support my weight on that arm (it was also giving me ‘pins and needles’) so I had to return to my original position.
By about 7:00 in the morning (of the 11th), I was feeling exhausted, and beginning to feel that I couldn’t go on. Suddenly, instead of being able to ‘breathe’ through the contractions any more, every time a contraction came I felt like simultaneously vomiting and bursting into tears but could do neither. Dr. Dott returned and decided to examine me (they limit the number of internal examinations if waters have broken early because of the risk of infection). It transpired that after 6-7 hours on the pitocin, I was only 4 cm dilated. He said that I probably had another 6 hours to go. Basically, at this point, I just lost it. I felt that there was no way I could endure that many hours again. I began telling people (essentially Sheep, Dr. Dott, Laurie the midwife from Dr. Dott’s practice and Mary, a Northside hospital nurse) that I couldn’t go on and there was a discussion about what to do. I still didn’t want an epidural, for various reasons, but I was beginning to wonder if I would have to. As an alternative, I was given the option of taking a temporary narcotic, fentanyl (which incidentally was the gas purported to have been used by the Russian government in the recent Moscow theatre siege!) administered through my IV drip. Its onset and peak occurs within minutes and its duration is about 30 to 60 minutes. It doesn’t block out the pain, but dulls it or ‘takes the edge off’ it. I agreed to this and once it had been administered, I fell asleep instantly! I think I was asleep for about half an hour. Unfortunately, on awaking I found that the contractions were as fierce as ever and still felt like I couldn’t continue. At this point Sheep and Dr. Dott left the room to discuss other options, namely an epidural. Sheep communicated my concerns about epidurals to Dr. Dott, but I think that both of us were beginning to anticipate that it might be the next step. At the end of their discussion, Sheep suggested that they examined me once more, just so that they could make an more informed decision. I’m glad he did, since on further examination it transpired that I had rapidly progressed from 4cm to 8cm dilation and was beginning to feel the need to push.
Once I could push, everything became so much easier and I felt like I had a lot of control over the pushing. In my mind, this stage went really, really quickly, perhaps half an hour, although it was clearly longer in reality. The only difficult part of this stage was when the head was emerging you feel like you’re being split in two. However, it was all over surprising quickly, and before I knew it there was a warm, wriggly thing between my legs, and then this warm, wriggly thing dumped onto my stomach. My only thought at this stage was how big he seemed and how on earth had he ever got out of me. Dr. Dott invited Sheep to cut the cord, Sheep quickly declined, much to Dr. Dott’s amusement, I suspect. Apparently, by this stage there was rather a lot of people in the room but to be honest, there could have been a football team in there and I wouldn’t have noticed, the only people I was aware of at the end were Sheep, Dr Dott and the nurse, Mary. After that, they took Aidan Barnaby away for tests the placenta was delivered quite rapidly, within minutes (to my surprise, I was expecting that stage to be longer) and intact and almost immediately I began to feel much better. I was amazed at how quickly I bounced back from the delivery.
Footnote about pitocin-induced labours. I read an article on the Internet about induced labours which said “A first-time mother with a long, firm, closed cervix… has truly dismal chances for vaginal birth [following an induced labor]; as many as half of these labors will end in cesarean section.” It went on to say, “Perversely, though, if a woman’s doctor has a high cesarean rate, inducing or awaiting spontaneous labor may not matter. It will make no or only a small difference to her chance of cesarean.” I am only thankful that I had Dr. Dott attending me at my delivery, since his rate of cesarean section is significantly less than the average rate of physicians at Northside hospital. All in all, I feel that I was extremely lucky. And of course, the outcome (Aidan Barnaby) is wonderful.